Balantidium coli apendicular como hallazgo incidental. Reporte de un caso / Apendicular balantidium coli as incidental finding during surgery. Report of a case

Resumen Balantidium coli es el único miembro de la familia Balantidiidae capaz de producir infección en seres humanos. Presentamos un caso en un hombre de 43 años que ingresa para corrección quirúrgica de hernia ventral durante la cual se realizó apendicetomía profiláctica. En el estudio histopatológico se observó apéndice cecal con arquitectura conservada, sin la presencia de apendicitis ni periapendicitis. En la luz se reconocieron estructuras grandes (aproximado de 50 μm) redondas con citoplasma amplio con vacuolas grandes, cilias periféricas y núcleos densos, los cuales correspondieron a trofozoitos de Balantidium coli.

Abstract Balantidium coli is the only member of the Balantidiiae family capable of infecting human beings. We present one in a 43 years-old male admitted for a surgical co rrection of an incisional hernia with prophylactic appendicectomy. Histopathological findings reported the cecal appendix within normal architecture, appendicitis and peri-appendicitis free. At the lumen big, rounded shape structures (aprox. 50 mm) were visible with broad cytoplasm, big vacuoles, peripheral cilia and dense nucleus, corresponding to Balantidium coli trophozoites.

Alta prevalência de Balantidium coli em crianças de uma Escola Municipal de Moreira Sales - Pr / High prevalence of balantidium coli in children of a Municipal School in Moreira Sales - Pr

As doenças causadas por parasitos intestinais estão entre os mais frequentes agravos do mundo, pois é um problema de saúde pública que atinge a maioria da população. O presente estudo teve como objetivo verificar a prevalência de parasitos em crianças de 4 a 6 anos de uma escola municipal de Moreira Sales, PR. A pesquisa foi composta por inquérito parasitológico e epidemiológico em crianças matriculadas em uma escola municipal em julho de 2017. O critério para inclusão no estudo foi: coletar a amostra de fezes, responder o questionário socioepidemiológico e ter o Termo de Consentimento Livre e Esclarecido (TCLE) assinado pelos pais e/ou responsáveis. Participaram do estudo 42 crianças com idades entre 4 e 6 anos, das quais 66,7% eram meninas. Dos participantes, dez crianças (23,8%) apresentaram infecção por Balantidium coli, sendo que destas, duas apresentaram infecção mista por Entamoeba coli. Foi observado que a maioria dos infectados possuíam animais de estimação (60%), roíam unhas (60%), consumiam hortaliças (80%) e todas as crianças brincavam na terra, sendo esses alguns fatores de risco para a infecção. Diante dos resultados apresentados, é possível perceber que existem vários fatores que podem estar associados à infecção por Balantidium coli, sendo os principais: falta de saneamento básico e os hábitos de higiene inadequado. Portanto, fatores importantes para se promover a conscientização e ação profilática da população, com o intuito de minimizar as parasitoses, principalmente nas crianças.

Diseases caused by intestinal parasites are among the most frequent ones in the world, since it is a public health issue affecting most of the population. The purpose of this study was to verify the prevalence of parasites in children aged 4 to 6 years at a school in the municipality of Moreira Sales, in the state of Paraná, Brazil. The study was comprised by the parasitological and epidemiological investigation in children enrolled in a school in the city in July 2017. The criteria for inclusion in the study was to collect the stool sample, answer the socio-epidemiological questionnaire and sign a Free and Clarified Consent Form. A total of 42 children took part in this study, with ages ranging between 4 and 6 years, of which 66.7% were female. From the participants, ten children (23.8%) presented infection by Balantidium coli, and among which, two of them presented mixed infection by Entamoeba coli. It was observed that most of the infected children had pets (60%), bit their nails (60%), consumed vegetables (80%) and all children played on dirt, which are some of the risk factors for infection. Considering the results, it is possible to observe that there are several factors that can be associated to infection by Balantidium coli, among which: basic sanitation and hygiene habits. Therefore, raising awareness and presenting prophylactic action to the population is essential in order to minimize intestinal parasitosis, especially in children.

Fatal parasite-induced enteritis and typhlocolitis in horses in Southern Brazil / Enterites e tiflocolites parasitárias fatais em equinos no Sul do Brasil

Abstract Diseases related to the alimentary system are the main cause of death in horses. This retrospective study aimed to describe the pathological findings of fatal parasite-induced enteritis and typhlocolitis caused by cyathostominae, Eimeria leuckarti, Balantidium coli, and Strongyloides westeri in horses. The records of parasite-induced intestinal lesions in horses necropsied in Southern Brazil between 2005 and 2017 were reviewed. Ten horses had fatal parasitic enteritis and/or typhlocolitis, and the main causes were: cyathostominae typhlocolitis (6/10), E. leuckarti enteritis (1/10), S. westeri enteritis (1/10), B. coli colitis related to cyathostominae (1/10), and infection by multiple agents (1/10). Cyathostominae typhlocolitis showed marked mucosal thickening, with multifocal elevated nodules containing tangled filiform parasites. Microscopic examination revealed that the mucosa and submucosa had encysted parasitic structures surrounded by eosinophilic and granulomatous inflammation. E. leuckarti enteritis was microscopically characterized by macrogamonts, microgamonts, and oocysts inside the host cells. S. westeri enteritis showed microscopic atrophy of the villi with numerous mucosal encysted parasitic structures. B. coli typhlocolitis showed severe diffuse mucosal reddening, with microscopic superficial mucosal necrosis associated with multiple protozoan trophozoites. Fatal parasite-induced enteritis and typhlocolitis are important causes of death in horses in Southern Brazil.

Resumo Doenças relacionadas ao sistema alimentar são as principais causas de morte em equinos. Esse estudo teve o objetivo de descrever aspectos patológicos de enterites e tiflocolites parasitárias fatais por ciatostomíneos, Eimeria leuckarti, Balantidium coli e Strongyloides westeri, em equinos. Foi revisado o banco de dados de lesões intestinais parasitárias em equinos necropsiados de 2005 a 2017, no Sul do Brasil. Dez equinos apresentaram enterite e/ou tiflocolite parasitária fatal, e as principais foram: tiflocolite por ciatostomíneos (6/10), enterite por E. leuckarti (1/10), enterite por S. westeri (1/10), colite por B. coli com ciatostomíneos (1/10), e infecção por múltiplos agentes (1/10). A tiflocolite por ciatostomíneos exibia acentuado espessamento da mucosa, com nódulos multifocais elevados contendo parasitas filiformes. Microscopicamente, a mucosa e submucosa apresentavam estruturas parasitárias encistadas envoltas por inflamação eosinofílica e granulomatosa. A enterite por E. leuckarti era caracterizada microscopicamente por macrogamontes, microgamontes e oocistos no interior de células do hospedeiro. Microscopicamente, a enterite por S. westeri apresentava atrofia de vilosidades com numerosas estruturas parasitárias encistadas na mucosa. A tiflocolite por B. coli exibia avermelhamento acentuado difuso da mucosa, e microscopicamente necrose superficial associada a múltiplos trofozoítos protozoáricos. Enterites e tiflocolites fatais parasitárias são importantes causas de morte em equinos no Sul do Brasil.

The First Case of Diarrhoea in Tibetan Sheep, Ovis aries, Caused by Balantidium coli in the Qinghai Tibetan Plateau Area, China

This study was carried out to determine the pathogen-causing diarrhoea in sheep Ovis aries in the Qinghai Tibetan Plateau Area, China. A trophozoite was identified as species of ciliate alveolates infecting the sheep based on morphological characteristics examined by microscope. It was mostly spherical, colourless and transparent, with many vesicles. Macronucleus and contractile vacuoles could not be distinguished. Size of the trophozoite was 80–180×70–150 μm and its surface was covered with cilia. Molecular analysis based on sequences of 18S rRNA and ITS genes confirmed the ciliate species as Balantidium coli. According to the literature, there have been many epidemiological investigations of B. coli infection in pigs, monkeys and humans. To our knowledge, this was the first report of B. coli infections in sheep in the Qinghai Tibetan Plateau Area of China, or eleswhere around the world. Importantly, the sheep case was rare but raised our concern that B. coli may spread across species and expand its host range.

Comparison of five parasitological techniques for laboratory diagnosis of Balantidium coli cysts / Comparação de cinco técnicas parasitológicas para diagnóstico laboratorial de cistos de Balantidium coli

Abstract Balantidium coli is a protozoon that can cause dysentery in humans, pigs and nonhuman primates, with zoonotic potential. In the literature, there is still little information on the effectiveness of different laboratory techniques for diagnosing this disease. This study compared and evaluated the performance of the Lutz, modified Ritchie, Faust, modified Sheather and direct examination techniques for detecting cysts of this protozoon. Between 2012 and 2014, 1905 fecal samples were collected from captive animals in the state of Rio de Janeiro. Of these, 790 were obtained from the rectum of pigs and 1115 from enclosures occupied by nonhuman primates. B. coli cysts were most evident through direct examination (22.4% of the samples) and the Lutz technique (21%). Fair agreement (Kappa = 0.41; p < 0.05) was observed only between direct examination and Lutz. The flotation techniques (Faust and modified Sheather) did not show good recovery of cysts. A statistically significant difference (p < 0.05) in the frequency of cysts between pigs and nonhuman primates could only be observed through direct examination and the Lutz technique. The most efficient method for diagnosing this parasitosis was seen to an association between direct examination and the spontaneous sedimentation technique.

Resumo Balantidium coli é um protozoário que pode determinar disenteria em humanos, suínos e primatas não humanos apresentando potencial zoonótico. Na literatura ainda são escassas as informações sobre a eficiência das diferentes técnicas laboratoriais para o diagnóstico dessa parasitose. Este estudo comparou e avaliou o desempenho das técnicas de Lutz, Ritchie modificada, Faust, Sheather modificada e do exame direto para a detecção de cistos desse protozoário. Entre 2012 e 2014, foram coletadas 1905 amostras fecais de animais cativos no Estado do Rio de Janeiro. Dessas, 790 foram obtidas da ampola retal de suínos e 1115 dos recintos de primatas não humanos. Cistos de B. coli foram 22,4 % mais evidenciados pelo exame direto; e pela técnica de Lutz, 21% das amostras. Concordância regular (Kappa = 0,41; p < 0,05) foi observada somente entre exame direto e Lutz. As técnicas de flutuação, Faust et al. e Sheather modificada não apresentaram boa recuperação dos cistos. Diferença estatística significativa (p < 0,05) na frequência de cistos entre suínos e primatas não humanos pode ser observada somente no exame direto e na técnica de Lutz. A metodologia mais eficiente para diagnóstico dessa parasitose foi observada pela associação do exame direto e da técnica de sedimentação espontânea.

Advances in researches of balantidiosis / 中国血吸虫病防治杂志

Balantidiosis is a disease infected with Balantidium coli,and swine is the main infection source. The infection of B. coli may cause diarrhea,extra intestinal infection and co?infection with other pathogens and even intestinal necrosis. Strength?ening the manure management of both human and livestock,paying attention to personal hygiene and labor protection,and time?ly treatment of the patients are the main measures to control balantidiosis.

Gastrointestinal parasites of swine raised in different management systems in the State of Rio de Janeiro, Brazil / Parasitos gastrintestinais de suínos criados sob diferentes sistemas de manejo no Estado do Rio de Janeiro

From 2012 to 2013 were surveyed gastrointestinal parasites from pig farms located in different municipalities in the state of Rio de Janeiro. Fecal samples from 790 pigs were collected from the rectum on 88 family farms and 702 farms with industrial production. The samples were subjected to Faust et al., Sheather, Ritchie, Lutz and direct examination faecal techniques. The estimated parasite prevalence was 93.1% in family farms and 59.1% in industrial farms. Balantidium coli, coccidia and Entamoeba sp. were the parasites with the highest frequencies, and the male and female reproductive categories and fatteners pigs the most infected (p<0.05). Trophozoites of B. coli were most evident in stool samples from semi-solid followed by solid and diarrheal consistencies. Strongyles eggs and Trichuris suis have been detected exclusively in family farms. Ascaris suum eggs and Strongyloides ransomi showed low frequency. The high degree of parasitism, especially protozoa, indicates the need to reassess the management of pigs in both types of production...

De 2012 a 2013 foram pesquisados parasitos gastrintestinais de suínos de granjas localizadas em diferentes municípios do estado do Rio de Janeiro. Amostras fecais de 790 suínos foram coletadas da ampola retal, sendo 88 de propriedades familiares e 702 de granjas com produção industrial. As amostras foram submetidas às técnicas de Faust et al., Sheather, Ritchie, Lutz e exame direto. A prevalência estimada foi de 93,1% nas granjas familiares e 59,1% nas granjas industriais. Balantidium coli, coccídios e Entamoeba sp. foram os parasitos que apresentaram as maiores frequências, sendo as categorias machos e fêmeas reprodutoras e leitões de terminação as mais infectadas (p<0,05). Trofozoítas de B. coli foram mais evidenciados nas amostras fecais de consistências semi-sólida, seguida pelas fezes com consistências sólida e diarreica. Ovos de estrongilídeos e Trichuris suis foram detectados exclusivamente em criações familiares. Ovos de Ascaris suum e de Strongyloides ransomi apresentaram baixa frequência. O alto grau de parasitismo, principalmente de protozoários, indica a necessidade de reavaliação do manejo dos suínos em ambos os tipos de produção...

A Case of Pneumonia Caused by Balantidium coli in an Immunocompetent Patient / 대한임상미생물학회지

Balantidium coli is the only largest ciliated protozoon known to infect human and nonhuman primates. Balantidiasis is a zoonotic disease and is acquired by humans via fecal-oral contact between pigs and humans. The clinical manifestation includes mainly gastrointestinal symptoms; diarrhea and abdominal pain, but in rare cases extraintestinal spread to lungs has been reported. A few reports of B. coli were found in vaginal secretion, skin, gastric juice, and omentum, but there have been no previous isolated cases in the respiratory tract in Korea. We reported that the first case of pneumonia caused by B. coli in Korea in an immunocompetent 40-year-old woman who displayed symptoms of chest discomfort and cough, and was cured with metronidazole.

A case of Balantidium coli in the gastric juice of a neonate / 대한주산의학회잡지

Balantidium coli is the only pathogenic ciliate parasitizing humans. Balantidium coli is widely distributed in hogs, particularly in warm and temperate climates, and in monkeys in the tropics. It is infrequently pathogenic for man. Balantidium coli is considered as a possible pathogen in immunocompromised patients. The infection fundamentally affects the colon and cause variable clinical pictures, from asymptomatic to serious dysenteric forms. Apart from intestinal involvement there have been reports on lung, liver, vagina infection by Balantidium coli. Balantidium coli were observed in the gastric juice of neonate. this is first report of asymptomatic balantidiasis in neonate.

Balantidiasis in the gastric lymph nodes of Barbary sheep (Ammotragus lervia): an incidental finding

A 4-year-old female Barbary sheep (Ammotragus lervia) was found dead in the Gwangju Uchi Park Zoo. The animal had previously exhibited weakness and lethargy, but no signs of diarrhea. The carcass was emaciated upon presentation. The main gross lesion was characterized by severe serous atrophy of the fat tissues of the coronary and left ventricular grooves, resulting in the transformation of the fat to a gelatinous material. The rumen was fully distended with food, while the abomasum evidenced mucosal corrugation with slight congestion. Microscopic examination revealed the presence of Balantidium coli trophozoites within the lymphatic ducts of the gastric lymph node and the abdominal submucosa. On rare occasions, these organisms may invade extra-intestinal organs, in this case the gastric lymph nodes and abomasum.

Balantidium coli in an Asymptomatic Patient: A Case Report / 대한진단검사의학회지

Balantidium coli is widely distributed in hogs, particularly in warm and temperate climates, and in monkeys in the tropics. B. coli is the only pathogenic ciliate and is the largest protozoan parasitizing humans. Some individuals with B. coli infections are totally asymptomatic, whereas others have symptoms of severe dysentery similar to those seen in patients with amebiasis. We report a 5-year-old girl with asymptomatic balantidiasis. The patient was suffering from herpes zoster for several days. She did not have symptoms of dysentery or urinary tract infection. Motile trophozoites of B. coli were observed in the urinary sediment. This is the first report of asymptomatic balantidiasis in Korea.